Clin Med
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Management of SAS and cardiovascular disease risk should be closely linked. It is important to screen for cardiovascular disease risk in patients with SAS and vice versa. ⋯ In the longer-term, CPAP should be used alongside standard cardiovascular risk reduction strategies including robust weight management programmes, with referral for bariatric surgery in appropriate cases. CPAP and NIV should be considered for acute admissions with decompensated cardiac failure.
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Keeping well during Hajj is a challenge for people with diabetes. However, with proactive planning and education, it may prove to be an excellent opportunity for reviewing management and enhancing diabetes education to reduce diabetes-related short- and long-term problems. People with diabetes should have enough time to consider a management plan. It is important that healthcare professionals are well informed regarding the effects of Hajj on diabetes and are able to offer advice, guidance and change of medications as required during pre-Hajj counselling to enable patients to stay healthy.
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Both the MRCP(UK) written examinations and the specialty certificate examinations (SCEs) use single-best-answer questions to assess the knowledge and problem-solving skills of physicians in training. Since 1999, specialists and senior trainees have created large banks of questions for these examinations that cover the relevant curricula. ⋯ Each question drafted is subjected to face-to-face peer review and subsequent stages of academic scrutiny before reaching the question bank, and later during the exacting processes of question selection and standard setting. Feedback to question writers at every level of scrutiny helps to support the development of question-writing competence, and the analysis of individual question performance provides some insight into optimal question design.
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ALF is a multisystem disorder necessitating both predictive and reactive management strategies to support and protect organs from the initial and subsequent insults encountered. Early referral to a specialist liver centre with the option of liver transplantation is recommended. Furthermore, a good understanding of the poor prognostic variables is necessary to determine those most at risk of developing ALF in order to facilitate timely, safe transfer and listing for liver transplantation.